Whether playing Stevens Park or Dallas National, golf’s big around here and across Texas. If you play enough, you may have developed a condition colloquially known as “golfer’s elbow.”
You can see why people call it that. The clinical term is ulnar nerve entrapment or cubital tunnel syndrome.
At Texas Neurosurgery, we can treat golfer’s elbow with various conservative methods. If these don’t alleviate the problem, we may recommend surgery. The procedure is called an ulnar nerve release.
What is the ulnar nerve?
The arm has three main nerves: the median nerve, the radial nerve, and the ulnar nerve. The ulnar nerve travels from your neck down into your hand. On this path, it can become constricted in several places along the way, such as beneath the collarbone or at the wrist. But because the ulnar nerve runs behind the inside part of the elbow where there can be compression, this is the most common spot for trouble.
At the elbow, the ulnar nerve travels through a tunnel of tissue called the cubital tunnel. This runs under a bump in the bone at the inside of the elbow, called the medial epicondyle. The spot where the nerve runs under the medial epicondyle is commonly referred to as the funny bone. At this spot, the nerve is relatively close to the skin, so bumping this area causes a shock-like feeling, hitting your “funny bone.”
After it passes the elbow, the ulnar nerve travels under muscles on the inside of your forearm and into your hand on the outer side of the palm (away from the thumb).
What does the ulnar nerve control?
The ulnar nerve allows us to sense feeling in the little finger and the outer half of the ring finger. It also controls most of the muscles in the hand that control fine movements. It also controls some of the bigger muscles that allow us to make a strong grip.
What’s going on?
It may seem odd that the ulnar nerve can become compressed, as it is on the inside of the arm. But it travels through a narrow space with little soft tissue to protect it. In many cases, there isn’t a direct cause/effect for cubital tunnel syndrome, but these are common causes of compression in the ulnar nerve at the elbow:
- When your elbow is bent, the ulnar nerve must stretch around the boney ridge of the medial epicondyle. This stretching can irritate the nerve, resulting in numbness in the fingers. This can occur when your elbow is bent for long periods of time, such as sleeping with your elbow bent.
- The nerve can slide out from behind the medial epicondyle when the elbow is bent. Repetition of this causes irritation. This can happen with the repetitive uses of the golf swing, particularly short shots.
- Leaning on your elbow for long periods of time puts pressure on the nerve.
- Fluid buildup in the elbow can cause compression.
When it becomes serious
Everyone has occasional tingling and numbness in his or her pinky and ring finger associated with the ulnar nerve. But, if the condition lasts or the symptoms are severe, you run the risk of muscle wasting that is irreversible.
At Texas Neurosurgery, our first treatment approaches are always conservative. But if those are not successful in alleviating your ulnar nerve compression, we may recommend ulnar nerve release surgery.